Glaucoma causes optic nerve damage from fluid buildup in the eye. It is the second leading cause of blindness in the world, and if it is left untreated, it can cause permanent vision loss and blindness. Treatments, like eye drops, laser treatments, and surgeries, can slow down or prevent vision loss.
What Is Glaucoma?
Glaucoma is a group of eye diseases that damage your eye’s optic nerve. The most common type is called open-angle glaucoma, and it is what most people are referring to when they say “glaucoma.” Open-angle glaucoma usually happens when fluid builds up in the front part of your eye, and that fluid increases the pressure in your eye, which causes damage to the optic nerve. But glaucoma can also happen even with normal eye pressure.
Glaucoma is more common in older adults, and it is one of the leading causes of blindness in people over the age of 60.
Many forms of glaucoma have no warning signs or symptoms, so you may not notice a change in vision until the condition is in its later stages. For this reason, it’s important to have regular, comprehensive, dilated eye exams and have your eye pressure tested. Vision loss can be slowed or prevented if glaucoma is recognized early. If you have glaucoma, you’ll need treatments and regular monitoring to keep it in check.
Symptoms of Glaucoma
Symptoms depend on the type of glaucoma you have and the stage of the condition.
Open-Angle Glaucoma
- No symptoms in early stages
- Gradually, patchy blind spots in your side or peripheral vision
- In later stages, difficulty seeing things in your central vision
Acute Angle-Closure Glaucoma
- Severe headache
- Severe eye pain
- Nausea and vomiting
- Blurred vision
- Halos or colored rings around lights
- Eye redness
Normal-Tension Glaucoma
- No symptoms in early stages
- Gradually, blurred vision
- In later stages, loss of peripheral vision
Glaucoma in Children
- Dull or cloudy eye (infants)
- Increased blinking (infants)
- Tears without crying (infants)
- Blurred vision
- Nearsightedness that gets worse
- Headache
Pigmentary Glaucoma
- Halos around lights
- Blurred vision with exercise
- Gradual loss of side vision
Types of Glaucoma
There are multiple types of glaucoma. Open-angle glaucoma is the most common, and angle-closure glaucoma is the most serious.
Open-Angle Glaucoma
Open-angle glaucoma happens gradually, where the eye does not drain fluid as well as it should. As a result, eye pressure increases and starts to damage the optic nerve. This type of glaucoma is painless and causes no vision changes at first.
Some people can have optic nerves that are sensitive to normal eye pressure, which means their risk of getting glaucoma is higher than normal. Regular eye exams are essential to find early signs of damage to their optic nerves.
Angle-Closure Glaucoma (or Closed-Angle/Narrow-Angle Glaucoma)
Angle-closure glaucoma happens when the iris is very close to the drainage angle in the eye, and the iris can end up blocking the drainage angle. When the drainage angle gets completely blocked, eye pressure increases very quickly. This is called an acute attack. It is an emergency, and you should see an eye doctor right away, or you can go blind.
Here are the signs of an acute angle-closure glaucoma attack:
- Sudden blurred vision
- Severe eye pain
- Nausea and vomiting
- Seeing rainbow-colored rings or halos around lights
Many people with angle-closure glaucoma develop it slowly. This is called chronic angle-closure glaucoma. There are no symptoms at first, so you don’t know you have it until the damage is severe or you have an acute attack.
Angle-closure glaucoma can cause blindness if it is not treated right away.
Glaucoma Causes & Risk Factors
Scientists aren’t sure what causes the most common types of glaucoma. However, many people with glaucoma have high eye pressure, and treatments that lower eye pressure help slow the disease.
There’s no way to prevent glaucoma, which is why regular eye exams are so important. That way, you and your doctor can find out about the condition before it affects your sight.
You’re at higher risk for glaucoma if you:
- Have high internal eye pressure, also known as intraocular pressure
- Are over age 55
- Have Black, Asian, or Hispanic heritage
- Have a family history of glaucoma
- Have certain medical conditions, such as diabetes, migraines, high blood pressure, and sickle cell anemia
- Have corneas that are thin in the center
- Have thinning of the optic nerve
- Have extreme nearsightedness or farsightedness
- Had an eye injury or certain types of eye surgery
- Take corticosteroid medicines, especially eye drops, for a long time
Some people have narrow drainage angles, which puts them at an increased risk of angle-closure glaucoma.
Glaucoma Diagnosis & Testing
The only sure way to diagnose glaucoma is with a complete, dilated eye exam. An exam that only checks your eye pressure is not enough to find glaucoma.
Dilating eye drops are used to dilate, or widen, your pupil. This allows the doctor to better see your retina and optic nerve for signs of damage.
During an exam for glaucoma, your eye doctor will:
- Measure your eye pressure
- Inspect your eye’s drainage angle, where the iris and cornea meet
- Examine your optic nerve for damage
- Test your peripheral vision
- Take a picture or computer measurement of your optic nerve
- Measure the thickness of your cornea
Glaucoma Treatments
Damage from glaucoma is permanent, meaning it cannot be reversed. But there are treatments available to slow or stop further damage.
Medication
Many types of prescription eye drops can treat glaucoma. Some decrease fluids and increase drainage to improve eye pressure. Because glaucoma is a lifelong condition, you may need to use eye drops daily or multiple times a day.
Bimatoprost is a glaucoma treatment that has been available as eye drops. The U.S. Food and Drug Administration (FDA) approved a new delivery method for bimatoprost, an implant that dissolves and works for several months. Your eye doctor places the bimatoprost implant (Durysta®) into your eye. Currently, you can only have it placed once in each eye.
Laser Therapy
For this treatment, your eye doctor uses a laser to help improve fluid drainage from your eye. Your eye doctor may suggest laser therapy as a first-line treatment instead of eye drops or in addition to eye drops. Having laser therapy may not replace the use of eye drops completely. The results from laser therapy treatments vary, but can last for years in some cases. Your eye doctor may be able to repeat some types of laser treatments.
Eye Surgery
Eye surgery can achieve better eye pressure control faster than drops or lasers. It can help slow down vision loss, but it can’t restore lost vision or cure glaucoma. There are many types of glaucoma surgeries available, and your eye doctor will choose one or the other depending on your specific type of glaucoma and the severity of your condition.
For example, there is traditional glaucoma surgery and minimally invasive glaucoma surgery (MIGS). There are also multiple types of MIGS procedures, including different stents or devices used to improve the flow of fluid out of your eye. MIGS procedures usually take less time to perform, have a faster recovery time, and have potentially fewer risks than traditional glaucoma surgeries. The types of surgeries available for glaucoma, especially MIGS procedures, are continuing to expand and evolve.
Get Regular Eye Exams to Detect Glaucoma Early
Early detection of glaucoma through routine eye exams is the best way to prevent vision loss.
Glaucoma testing should occur every:
- One to three years after age 35 for people at high risk
- Two to four years before age 40
- One to three years between ages 40 and 54
- One to two years between ages 55 to 64
- Six months to 12 months after age 65
The earlier you catch glaucoma and start treatments, the better the odds of saving your vision. If you’re at high risk for glaucoma, you should get regular eye exams. The recognized ophthalmologists at Toledo LASIK can help you detect glaucoma and begin treatments to slow down disease progression and vision loss.
